Establishing new forms of collaboration that promote health: recommendations for SMEs

🔍💡 Self-organisation and mental health: Swiss SMEs that adopt holacracy, shared leadership, or agile methods experience reduced stress and increased autonomy among their employees. A 4-step model to sustainably transform your organisation while preserving mental health. #healthpractices #WorkHealth #Holacracy #SharedLeadership #SMEs #MentalHealth #SelfOrganisation #AgileMethod

Source: 📒 Establishing new forms of collaboration that promote health: recommendations for SMEs

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Number of pages: 13 pages

This document provides SME managers, HR leaders, occupational health prevention specialists, and social care actors with an operational model in four steps to transform work organisation. It demonstrates with recent Swiss data (FlexWork 2024 study) that new forms of collaboration significantly reduce stress and burnout while enhancing autonomy. The two practical case studies of Swiss companies (Liip and seerow) provide replicable examples to support this organisational change that is beneficial for mental health.

1. ANALYTICAL SUMMARY

Context and challenges: SMEs facing the increasing complexity of the market

Small and medium-sized enterprises operate in a context of rapid change and increased complexity that requires greater organisational agility. Although many SMEs already practice some form of informal self-organisation, this is rarely formalised. The document draws on the FlexWork 2024 study conducted in Switzerland and a systematic literature review (Krause et al., 2025) to demonstrate that three categories of new forms of collaboration are emerging: the adaptation of organisational structures (holacracy, sociocracy), the adaptation of management approaches (shared leadership, distributed leadership), and the adaptation of teamwork (self-organising teams, agile methods such as scrum and kanban). These approaches respond to a need for participation, shared responsibilities, and organisational resilience in a volatile market. Swiss data reveal that 59% of employees consider their team to be self-organised, with a particularly high proportion in micro-enterprises (p. 4).

Operational contributions: a structured model and scientific evidence

The document provides a scientifically validated practical four-step model for implementing these transformations in a health-promoting manner: 1) check the prerequisites (clarify the "why", ensure time availability), 2) lay the structural foundations (define roles, duties, decision-making processes, provide training), 3) implement gradually (start small, involve collaborators, remain open to adjustments), 4) evaluate the impact and identify friction points (promote psychological safety, develop common solutions). Documented empirical results show that these forms of collaboration increase autonomy, social support, well-being, and reduce stress and burnout (p. 4). The document includes concrete testimonies from two Swiss SMEs (Liip with over 200 employees in holacracy, seerow with more than 10 employees who have adopted the four-day week) that illustrate the feasibility and measurable benefits of these approaches (p. 6-9).

2. KEY POINTS OF THE DOCUMENT

1. New forms of collaboration fall into three complementary categories(p. 2-3)

Organisational transformations are not limited to remote work or flexible hours. Three main axes structure the new forms of collaboration: the adaptation of organisational structures that eliminate traditional hierarchical levels in favour of participatory models (holacracy practised by 2% of the Swiss workforce, sociocracy); the adaptation of managerial approaches where employees without managerial roles take on a share of responsibility in defining priorities and external representation (13% practise shared leadership); the adaptation of teamwork with self-organising teams that use agile methods (kanban 10%, scrum 8%). These approaches are closely linked and mutually reinforce each other to create resilient organisations capable of facing increasing uncertainty and complexity.

2. The positive impacts on mental health far outweigh the identified risks(p. 4-5)

Contrary to the common belief that these forms of collaboration generate more stress, empirical results reveal an opposite reality: the positive impacts on mental health are much more pronounced than the risks involved. Documented beneficial effects include increased autonomy in daily work, a greater sense of belonging and social support, enhanced well-being and job satisfaction with a reduction in workload, as well as a decreased sense of stress and burnout. These effects are accompanied by an increase in performance and capacity for innovation. The more consistently the approaches are applied, the greater the health benefits. Risks (role conflicts, burnout, work intensification, hindered self-organisation) generally occur when implementation is inconsistent or insufficiently supported, indicating a need for optimisation.

3. Self-organisation is already widespread in Swiss SMEs but rarely formalised(p. 4)

The FlexWork 2024 study reveals that self-organisation is as prevalent in SMEs as in large companies, and is particularly pronounced in micro-enterprises (2-9 employees). 59% of participants consider their team to be self-organised, 55% indicate that they decide on the organisation of work collectively, 44% state that all members are involved in decision-making processes, and 51% regularly question their work. In contrast, standardised methods such as scrum or kanban are more frequently used in large companies. For SMEs that are already operating daily in a self-organised mode, formalising these practices with agile methods can create stability, help teams orient themselves better, and ensure long-term success in the face of the increasing complexity of the market.

4. A four-step model structures the health-promoting implementation(p. 6-9)

The proposed model allows SMEs to approach transformation in a gradual and tailored manner.Step 1 - Prerequisites: clarify the "why" (what problem to solve?), check the willingness to share responsibilities, ensure that the workload allows for this transition.Step 2 - Foundations: clearly define roles, duties, and decision-making processes (it is more important that the rules are sensible rather than exhaustive), provide training and occasional support (agile coaches, external consultants), create internal support functions.Step 3 - Implementation: start with modest and easy-to-implement changes, actively involve employees from the beginning, establish rule monitoring (15 minutes per month), remain open to adjustments, test in a pilot phase (6 months at Liip).Step 4 - Impact: detect friction points early, promote psychological safety and a feedback culture, consciously address work-life balance. This process is cyclical, non-linear, often requiring a return to a previous step for more clarity or support.

5. The consistency of implementation determines the extent of beneficial effects(p. 4)

The effectiveness of new forms of collaboration directly depends on the consistency of their application. When an agile method like Scrum is introduced, its positive impact will be stronger the more consistently it is applied in daily work: systematically organised retrospectives, clearly defined responsibilities, short feedback loops introduced, teams having the necessary freedom to make decisions autonomously. If only certain elements of a method are adopted (for example, the daily stand-up) without anchoring the underlying principles, the positive effects diminish. Studies show that implementation is also possible in hierarchical companies: even if partial solutions may generate contradictions, the opportunities outweigh the risks for employees.

3. ACTIONABLE STEPS FOR LOCAL ACTORS

1. Assess the relevance of new forms of collaboration according to the complexity of tasks(p. 11)

Use the matrix presented in figure 5 to determine whether the organisation would benefit from formalising self-organisation. New forms of collaboration are particularly suited to managing complex situations (ambiguous problems, unclear or unusual solutions). For simple tasks with clearly established processes, work routines and clear instructions are sufficient. For complicated tasks, agile practices such as the kanban board offer proven analytical methods. Identify within your structure the areas where complexity justifies an organisational transformation (innovation, bespoke projects, rapid adaptation to customer demands) and those where existing processes remain effective.

2. Start with a self-assessment of the informal practices already in place(p. 4, 8)

Before introducing new methods, map the existing informal self-organisation practices in your SME: who makes which decisions autonomously? How do teams currently coordinate? Which participatory processes are already working well? Involve employees in this assessment during brief team meetings or feedback loops. This approach helps identify what deserves to be formalised and what is already functioning well enough without additional rules. Start with modest and easy-to-implement changes: clear decision-making processes, weekly exchange formats, and a 15-minute rule check per month to verify their relevance.

3. Establish internal support roles to assist with the transition(p. 7)

Take inspiration from the example of Liip, which has created internal support roles (holacracy assistants in case of conflicts, peer coaches for personal development) that employees can turn to for targeted support. These roles provide assistance during the change process without necessarily requiring the intervention of costly external consultants. Identify individuals in your teams who have an affinity for facilitation, mediation, or coaching and train them for these support roles. Also plan occasional training sessions to help employees and managers understand and apply the new roles and ways of working, particularly for those with little experience in self-organisation.

4. Establish a culture of feedback and psychological safety from the outset(p. 8)

Foster trust-based relationships grounded in open communication and a culture of feedback to facilitate the early detection of warning signs (uncertainties related to responsibilities, workload overload). Implement simple tools such as short surveys on psychological safety integrated into regular communication channels (for example, Liip with smileys in the chat). Regularly organise dedicated retrospective sessions: what worked well? What do we need to improve? Create spaces where employees can openly discuss mistakes and criticism without fear of negative consequences. Strengthen transparency in decision-making and open communication about mistakes to create an environment where everyone feels safe to report difficulties before they become critical.

5. Proceed by iterations with pilot phases and continuous adjustments(p. 8-9)

Adopt an experimental approach by testing new forms of collaboration over a defined period (for example: a 6-month pilot phase at Liip, regular inquiries at seerow). Systematically gather feedback from employees during this phase: how is it going? What is working well? What are the weaknesses? Plan targeted adjustments rather than abandoning everything if certain aspects do not work perfectly: keep the 70% that works and revisit the aspects needing optimisation. Accept that the process is cyclical and not linear, sometimes requiring a return to a previous stage (from implementation to basics) when more guidance, support, or clarity is needed. Formalise the rules of collaboration in an accessible manual (for example, seerow) while planning for their regular revision.

4. ADDITIONAL REFERENCES

5. CROSS-ANALYSIS — VALUES OF HEALTH PRACTICES

Literacy:The document provides a detailed glossary (p. 10) defining key concepts (holacracy, kanban, scrum, shared leadership, etc.) and uses accessible language with concrete examples, facilitating understanding for field actors with varying levels of familiarity with these organisational approaches.

Empowerment:Beneficiaries (collaborators) are central to the design as new forms of collaboration are based on the principles of shared responsibilities, self-organisation, and decentralised decision-making; the examples of Liip and seerow show a direct involvement of collaborators in the evaluation and adjustment of practices (p. 7-8).

Participation:The co-construction mechanisms are explicitly described through the four-step model, particularly step 3 which emphasises the active involvement of collaborators, the collection of feedback from the outset, and regular feedback loops to test and adjust ideas (p. 8).

Community health:The collective dimension is fully integrated through the concepts of self-organised teams, collective resilience in the face of challenges, mutual support enhancing resilience, and psychological safety promoting open communication within groups (p. 5).

Ethics:The document explicitly identifies potential risks (role conflicts, burnout, work intensification) and proposes solutions to prevent them, demonstrating an ethical approach attentive to possible negative effects; biases related to work intensification and blurred work-life boundaries are addressed (p. 5, 8).

Human rights:The approach respects the principles of equity by promoting the participation of all team members in decision-making processes (44% of Swiss teams involve all members, p. 4) and valuing individual autonomy and the sense of self-efficacy as fundamental rights at work.

Intersectorality:The document recommends the use of agile coaches or external consultants to foster collective reflection (p. 7), and relies on collaboration between the Federal Office of Public Health, Health Promotion Switzerland, and the University of Applied Psychology, illustrating an intersectoral approach to health-research-business.

Partnership:Collaboration models are formalised through the testimonies of two Swiss SMEs (Liip and seerow) that precisely describe the co-construction processes between management and employees, the functions of internal assistance, and the modalities for regular consultation (p. 6-9).

Combating discrimination:The document mentions the importance of psychological safety, allowing for open discussion of mistakes and criticism without fear of negative consequences (p. 5), thus fostering a non-judgmental environment; the diversity of roles and the removal of traditional hierarchies aim to reduce discrimination related to status or hierarchical position.

6. EVALUATION OF THE RELIABILITY OF THE RESOURCE

Scientific relevance:A resource of very high scientific reliability based on a systematic review of recent literature (Krause et al., 2025) examining the empirical foundations, on the FlexWork 2024 study with significant samples (micro-enterprises n=225, small n=316, medium n=412, large n=879), and on a solid bibliography of 16 recent academic references (2015-2025) including peer-reviewed journals. The authors are researchers from the University of Applied Sciences of Northwestern Switzerland, ensuring academic expertise. The data is current (2024-2026) and the methodology is transparent with complete bibliographic references.

Operational relevance:Excellent direct usability in the field thanks to the structured and actionable four-step model (p. 6-9), clearly listed practical advice for SMEs (p. 8), two concrete case studies of Swiss companies with direct testimonials and replicable examples, a glossary facilitating the appropriation of concepts (p. 10), and Figure 5 (p. 11) providing a diagnostic tool for the relevance of new forms according to task complexity. The 13-page information sheet format promotes quick reading while remaining comprehensive.

7. MCQ — 5 QUESTIONS

PART 1 — Presentation of the MCQ

Question 1:According to the FlexWork 2024 study, what percentage of the Swiss workforce practices holacracy in a formalised manner?

a) Approximately 13%

b) Approximately 2%

c) Approximately 10%

d) Approximately 8%

Question 2:Among the following effects, which is NOT mentioned as a positive impact of new forms of collaboration on the mental health of employees?

a) Increased autonomy in daily work

b) Reduced feelings of stress and burnout

c) Increase in weekly working hours

d) Increased well-being and job satisfaction

Question 3:In the four-step model, what is the first recommended step for implementing new forms of collaboration?

a) Gradual implementation with pilot phases

b) Prerequisites: clarify the "why"

c) Impact: identify friction points

d) Foundations: define roles and decision-making processes

Question 4:At Liip, what duration of pilot phase was chosen to test holacracy before generalisation?

a) 3 months

b) 12 months

c) 9 months

d) 6 months

Question 5:According to the document, in what type of situation are new forms of collaboration particularly relevant?

a) When tasks are simple and processes are well defined

b) When problems are ambiguous and solutions are unclear or unusual

c) Only in large companies with more than 500 employees

d) When the company wants to reduce personnel costs

PART 2 — Commented correction

Question 1:According to the FlexWork 2024 study, what percentage of the Swiss workforce practices holacracy in a formalised manner?

✅ Correct answer: b) Approximately 2%

📝 Explanation:The FlexWork 2024 study indicates that for the adaptation of organisational structures, holacracy is practiced by approximately 2% of the Swiss workforce. This relatively low proportion shows that holacracy remains a minority approach but is developing. In contrast, 13% practice shared leadership, and kanban (10%) and scrum (8%) methods are also measured separately. —Source: p. 3

Question 2:Among the following effects, which is NOT mentioned as a positive impact of new forms of collaboration on the mental health of employees?

✅ Correct answer: c) Increase in weekly working hours

📝 Explanation:The document lists four main positive effects observed in employees: increased autonomy in daily work, enhanced sense of belonging and social support, increased well-being and job satisfaction with a reduced workload, and reduced feelings of stress and burnout. The increase in working hours is never mentioned as a positive effect; on the contrary, the document refers to the example of Seerow, which introduced a four-day week to reduce working hours. —Source: p. 4

Question 3:In the four-step model, what is the first recommended step for implementing new forms of collaboration?

✅ Correct answer: b) Prerequisites: clarify the "why"

📝 Explanation:The structured model presented in figure 4 begins with step 1 "Prerequisites" which involves clarifying why a new form of collaboration needs to be introduced, checking if managers and employees are ready to share responsibilities, and ensuring that the workload allows for this transition. The other steps follow in order: 2) Foundations, 3) Implementation, 4) Impact. This sequence ensures that the transformation is based on solid foundations before being deployed. —Source: p. 6

Question 4:At Liip, what duration of pilot phase was chosen to test holacracy before generalisation?

✅ Correct answer: d) 6 months

📝 Explanation:Liip's testimony states: "We tested holacracy as part of a six-month pilot phase." This period allowed for the collection of experiences and feedback from the field to adapt and refine the structures before a broader implementation. This duration of 6 months appears to be a compromise that allows for sufficient experimentation to identify necessary adjustments while maintaining a dynamic of change. —Source: p. 8, 9

Question 5:According to the document, in what type of situation are new forms of collaboration particularly relevant?

✅ Correct answer: b) When problems are ambiguous and solutions are unclear or unusual

📝 Explanation:Figure 5 and its explanation indicate that new forms of collaboration are particularly suited to managing complex situations, that is, when problems are ambiguous and solutions are unclear or unusual. For simple tasks with clearly established processes, work routines and clear instructions are sufficient. The example of carpentry illustrates this distinction: standard cutting and assembly are simple, but a custom piece of furniture requiring conceptual research falls into the complex area where new forms of collaboration make the most sense. —Source: p. 11

8. FREQUENTLY ASKED QUESTIONS (FAQ)

1. Are new forms of collaboration reserved for large companies, or can they apply to SMEs?

The new forms of collaboration are well suited to SMEs, which often already practice informal self-organisation. The FlexWork 2024 study reveals that self-organisation is as prevalent in Swiss SMEs as in large companies, and is particularly pronounced in micro-enterprises (2-9 employees). 59% of participants consider their team to be self-organised. The difference lies in the formalisation: large companies more frequently use standardised methods (scrum, kanban) whereas SMEs would benefit from structuring their existing practices to create stability and enable teams to better navigate the increasing complexity of the market. —Source: p. 4

2. What are the concrete risks to the health of employees and how can they be prevented?

Four main risks are identified: role conflicts (blurred responsibilities, contradictory expectations), burnout (blurred boundaries between work and private life, culture of "always connected"), work intensification (confused priorities, poorly structured iterative processes, tight schedules) and self-organisation hindrance (persistent micromanagement, "top-down" interventions, lack of support). These risks generally occur when implementation is inconsistent or insufficiently supported. Solutions include: role clarification workshops, agreements among colleagues on availability, realistic task planning, workload-focused retrospectives, transparency in decision-making processes, and targeted support for former managers in accepting new approaches. —Source: p. 5

3. Should we completely abandon the traditional hierarchy to implement these new forms of collaboration?

No, it is not necessary to completely abandon the hierarchy. Studies show that the implementation of new forms of collaboration is also possible in hierarchical companies. While such partial solutions may indeed generate contradictions, the results show that the opportunities outweigh the risks for employees. The key is to clearly define roles, responsibilities, and decision-making processes, even within a structure that retains certain hierarchical levels. The approach can be gradual: introducing agile methods in certain project teams while maintaining a more traditional structure elsewhere, or adopting shared leadership for specific managerial functions.Source: p. 4

4. How long should we expect to successfully transition to new forms of collaboration?

The duration varies depending on the scale of the change and the size of the organisation. The examples presented show that a 6-month pilot phase (Liip) allows for testing, gathering feedback, and adjusting practices before generalisation. The process is not linear: it is often necessary to return to a previous stage when more guidance, support, or clarity is needed. Continuous improvement is key: even after the initial implementation, stage 4 (Impact) allows for the identification of sensitive points requiring new adjustments. It is recommended to start with modest and easy-to-implement changes, then iterate gradually rather than aiming for an immediate radical transformation.Source: p. 8-9

5. What are the differences between holacracy, sociocracy, shared leadership, and agile methods?

These approaches fall into three different but complementary categories. Holacracy and sociocracy are adaptations of organisational structures: holacracy defines roles rather than hierarchical structures, with decisions made in a decentralised manner at the team level (circles), while sociocracy is an organisational form based on equality and the principle of consent, where decisions are developed collectively in circles until major objections are resolved. Shared leadership and distributed leadership are adaptations of management approaches where managerial tasks are shared among several people or taken on by different members depending on the situation. Agile methods (scrum, kanban, daily stand-ups, retrospectives) are adaptations of teamwork that allow for flexible, step-by-step work with regular feedback and adjustments.Source: pp. 2-3, 10

6. How can we concretely measure the impact of these new forms on the mental health of employees?

Several measurement tools are mentioned in the practical cases. Liip uses brief surveys on psychological safety integrated into the company chat, allowing for easy measurement of the work atmosphere using smileys. The company also regularly assesses psychological safety, working conditions, well-being, and health to continuously ensure it is on the right track and to monitor and influence changes. At Seerow, regular inquiries from employees are organised during pilot phases: "How is it going? What is working well? What are the weaknesses?" These simple and accessible tools allow for early detection of warning signals without requiring heavy or costly assessment devices. —Source: p. 8

7. What support should be provided for managers who need to learn to delegate their responsibilities?

Supporting managers is crucial as they may struggle to delegate their responsibilities (example Liip). Several forms of support are recommended: occasional training to help managers understand and apply the new roles and ways of working, intervention from agile coaches or external consultants to foster common reflection on what works or not, creation of internal support roles (holacracy assistants in case of conflicts, peer coaches for personal development) to whom they can turn for targeted support. Personal discipline is also essential: as Liip testifies, "not falling back into this pattern [of unilateral decision-making] requires a lot of discipline." Targeted support for former managers in understanding and accepting new managerial approaches helps facilitate this delicate transition. —Source: p. 5, 7, 8

9. REWRITING IN EASY LANGUAGE

New ways to work together to protect health

What is it?

New ways to work together exist in companies.

Teams decide for themselves how to do their work.

Everyone can give their opinion.

Responsibilities are shared among all.

Why is it important?

These new ways of working protect health.

People are less stressed.

People are less tired.

People feel better in their work.

People decide more for themselves.

How does it work in Switzerland?

In Switzerland, many teams already work like this.

59 out of 100 people say their team decides on its own.

This is especially true in small businesses.

But often, there are no written rules.

The 4 steps to get started

Step 1 - Understand why

Ask yourself: why change our way of working?

Check that everyone agrees.

Check that there is enough time.

Step 2 - Create clear rules

Write down who does what.

Write down how decisions are made.

Offer training if needed.

Step 3 - Try gradually

Start with small changes.

Ask often: how are you?

Change what isn't working.

Keep what works well.

Step 4 - Check that it works

Observe if people are feeling better.

Talk openly about problems.

Find solutions together.

What helps

Talk regularly as a team.

Say what is working and what isn't.

Trust the people.

Let people suggest ideas.

What to watch out for

Sometimes, people don't know who decides.

Sometimes, people work too much.

Sometimes, it is difficult to separate work and private life.

It needs to be discussed and solutions found.

Proven benefits

People feel freer in their work.

People help each other more.

People are more satisfied.

People have less stress.

The company performs better.

Examples from Switzerland

Liip: a company of over 200 people.

They changed their way of organising.

Now, everyone has a clear role.

Teams decide together.

They tested for 6 months before continuing.

Seerow: a small company of 10 people.

They work 4 days a week instead of 5.

They wrote the rules in a manual.

They change the rules if it doesn't work.

Everyone gives their opinion.

To remember

Start small.

Involve everyone.

Talk regularly.

Change what isn't working.

Keep what works.

These new ways of working protect health.

#healthpractices #WorkHealth #MentalHealth #SMEs #Holacracy #SharedLeadership #AgileMethods #SelfOrganisation #WorkLifeQuality #HealthPrevention #PsychosocialRisks #WorkWellbeing